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Published on: January 7, 2018
[Perinatal morbidity and mortality in children born to mothers with gestational hypertension]
B Galanti1, C T Kaihura, L Ricci
1Cattedra di Ginecologia e Ostetricia, Clinica Ostetrica e Ginecologica, Università degli Studi di Parma.
Insights
Gestational hypertension significantly increases risks for mothers and newborns, leading to premature birth, low birth weight, and higher still-birth rates. Key risk factors include advanced maternal age, nulliparity, and obesity.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Epidemiology
Context:
- Gestational hypertension is a serious pregnancy complication with significant maternal and neonatal implications.
- It is a leading cause of maternal morbidity and contributes to perinatal mortality through fetal hypoxia, prematurity, and low birth weight.
- Current management primarily involves delivery, with timing and method dictated by hypertension severity and maternal/fetal complications.
Purpose:
- To investigate the clinical course and identify risk factors for gestational hypertension.
- To compare maternal and neonatal outcomes between women with gestational hypertension and a healthy control group.
Summary:
- A clinical-epidemiological study analyzed 50 women with gestational hypertension and 80 controls.
- Identified risk factors for gestational hypertension include advanced maternal age, nulliparity, and elevated BMI.
- Hypertensive pregnancies resulted in higher rates of premature birth, cesarean sections, lower birth weights (newborn and placenta), reduced Apgar scores, increased NICU admissions, and a 14% still-birth rate.
Impact:
- Findings highlight the severe adverse effects of gestational hypertension on neonatal outcomes, including prematurity and mortality.
- Identifies key maternal risk factors, aiding in early risk assessment and potential intervention strategies.
- Emphasizes the critical need for vigilant monitoring and management of gestational hypertension to improve maternal and neonatal prognosis.
Abstract:
Gestational hypertension is a severe pathology leading to important maternal and neonatal effects. It represents one of the most important causes of maternal morbidity and contributes to a high percentage of perinatal mortality, determined by fetal hypoxia and especially by prematurity and low birth weight. To-date the only treatment offered in gestational hypertension remains delivery, which has to be scheduled regarding timing and method on the basis of the appearance of hypertension, of its severeness and maternal and fetal complications. To evaluate the clinical course and the presence of hypertensive risk factors, a clinical-epidemiological study was carried out on two groups of pregnant women: a group made up of 50 women with hypertension and a control group of 80 women in whom no gravidic pathology arose. We hence were able to reveal the risk factors associated with hypertension in pregnancy such as maternal age, nulliparity, and elevated body mass index. Regarding neonatal prognosis, we observed a higher incidence in premature birth (30th- to 38th week of gestational age) and the need for elective or urgent caesarean sections, with respect to the spontaneous deliveries observed in the control group. We also observed reduced weight of both placenta and the newborn in hypertensive mothers with significant statistical differences between the two groups (p < 0.001). Evaluation of neonatal data at birth showed lower Apgar indices at 1st and 5th minute from birth in the study group with a higher percentage of newborns transferred to the neonatal intensive care unit. We also observed a high percentage of still-births equal to 14% in the study group as opposed to the control group.
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